A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Age-Adjusted Mortality Rate:

Age is the most important characteristic governing mortality. Before the mortality experience of two or more populations can be compared, the difference in the age distributions of the population must be removed. This is accomplished through the use of an age-adjusted rate. Direct standardization weights the age-specific rates for a given sex, race/ethnicity or geographic area by the age distribution of the standard population. The 1970 U.S. standard million population was used as the standard for all age-adjusted mortality rate calculations on the TCDC Web site. (See Demographics and Statistics for more details.)

The formula to calculate age-adjusted mortality rates is:



Age-Specific Mortality Rate:

The age-specific mortality rate is calculated by dividing the number of deaths for a specific age group by the population for that specific age group. For example, deaths for age group 60 to 64 divided by the population for age 60 to 64.

American College of Surgeons (ACoS) Approved Programs:

Established in 1930, the Approvals Program of the Commission on Cancer surveys hospitals, treatment centers, and other facilities according to standards set by the Committee on Approvals, which recommends approval awards based on these surveys. The Approvals Program has experienced steady growth since its inception.

ACoS Categories of Approvals:

Programs are assigned a category of approval that describes the services available at the facility. Categories include:

• Community Hospital Cancer Program (CHCP):
  Facility offers a full range of diagnostic and treatment services, but referral for a portion of the treatment is common. The medical staff are board certified in the major medical specialties. Monthly or twice monthly cancer conferences are required depending on the number of analytic accessions. Facilities may participate in clinical research.
  
  
• Comprehensive Cancer Program (NCI-designated program) (NCIP):
  The NCI-designated Comprehensive Cancer Centers were established to be national leaders in cancer treatment, research, and education. This facility must first secure a National Cancer Institute peer-reviewed Cancer Center Support Grant. The facility has available a full range of diagnostic and treatment services and staff physicians with major specialty boards
  including those in oncology, where offered. The facility participates in both basic and clinical research and holds cancer conferences at least weekly.
  
  
• Community Hospital Comprehensive Cancer Program (COMP):
  Facility offers a full range of diagnostic and treatment services available, on site or by referral. The medical staff are board certified in the major medical specialties including those in oncology, where applicable. Clinical research is required if the program accessions 750 or more analytic cases annually and all facilities in this category hold at least a weekly cancer conference.
  
  
• Teaching Hospital Cancer Program (THCP):
  Facility with at least four residency programs, two of which are medicine and surgery. The facility offers the full range of diagnostic and treatment services available, on site or by referral. The medical staff are board certified in the major medical specialties including those in oncology, where applicable. The facility participates in clinical research and holds
  cancer conferences at least weekly.

Angiography:
Radiography (X-rays) of vessels after the injection of radiopaque material.

American College of Radiology (ACR) Accreditation:
The ACR created a nationwide accreditation program in 1987 to help ensure that women receive high quality mammography. In 1995, the College had accredited more than 10,000 mammography facilities across the country. Under the program, ACR evaluates the film, equipment and the personnel who take mammograms. Under the Mammography Quality Standards Act (MQSA) of 1992, once a facility is accredited it must then be approved for certification by the Food and Drug Administration.

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Basal Cell Carcinoma:
The most common form of skin cancer which, when detected and treated early, will usually result in a complete cure.

Biopsy:
The removal and examination, usually microscopic, of tissue from the living body, in order to establish a precise diagnosis.

Board Certification:
The intent of the certification of physicians is to provide assurance to the public that a physician specialist certified by a Medical Specialty Board has successfully completed an approved educational program and evaluation process which includes an examination designed to assess the knowledge, skills, and experience required to provide quality patient care in that specialty.

Body Mass Index:
A tool for indicating weight status; allows people to compare their own weight status to the general population. For adults over 20 years old, BMI falls into one of these categories:

BMI Weight Status Below 18.5 = Underweight 18.5 - 24.9 = Normal 25.0 - 29.9 = Overweight 30.0 and Above = Obese

Formula for calculating body mass index (BMI):

English Formula



Metric Formula



Bone Marrow Transplant:
Marrow is a substance found in the cavities of the body's bones. It resembles blood and contains stem cells, which produce red cells, white cells and other blood components. Marrow transplants are a treatment for patients with anemias, lymphomas and a number of other life-threatening blood diseases.

Built Environment:
The surroundings or conditions in which people live or operate.

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Cancer:
A class of more than 100 diseases, all of which are characterized by malignant uncontrolled cell growth that, left untreated, will prove fatal. All cancers have the capacity to metastasize, or form secondary tumors at other sites. See Carcinoma.

Cancer Cluster:
The occurrence of a greater than expected number of cancer cases within a geographic area, a group of people or a specific time period.

Cancer Committee:
The multi-disciplinary cancer committee must be designated as a standing committee in the bylaws of the participating institution.

Cancer Conference:
Physicians, nurses, cancer registrars and others involved in the diagnosis and treatment of patients with cancer participate in case-oriented meetings. These interdisciplinary conferences are held weekly, twice monthly or monthly, depending on the category of approval and the number of new cases at each institution. All major cancer sites that are seen at the institution are discussed during the year.

Cancer Liaison Physician:
Represents a single facility involved in cancer control and the management of patients with cancer; their role as the point person at each institution includes information gathering and exchange and acting as a link to the institution's administration, medical and allied health staff, cancer program leadership, as well as patients and their families.

Cancer Patient Evaluation:
Cancer programs are required to conduct two patient care evaluation studies each year. The evaluation of care must include oversight and action by the cancer committee into the study design, quality of data collection, review of the analysis, summary of the findings, identification of problems and solutions, initiation of corrective action, and follow-through to determine that corrective actions resulted in the desired change.

Cancer Program Components:
An approved cancer program has four components: the cancer committee, cancer conferences, patient care evaluation, and the cancer registry.

Cancer Registrar or Tumor Registrar:
Person who abstracts and records the data on cancer cases; oftentimes, that person is also responsible for assisting in planning the cancer conferences and the cancer committee meetings, and providing reports.

Cancer Registry:
Information about all malignancies that are diagnosed or treated in the institution is entered into the cancer registry database. This data allows the cancer committee to monitor patient follow-up and treatment results. The registry data is also valuable for planning resource allocations.

Cancer Survivor:
The Center for Disease Control and Prevention (CDC), Amerian Cancer Society (ACS), and National Cancer Institute (NCI) currently use the term cancer survivor to describe those who have been diagnosed with cancer and the people in their lives who are affected by the diagnosis, including family members, friends, and caregivers.

Carcinogenesis:
The production of cancer.

Carcinoma:
A malignant tumor of epithelial origin; refer to cancer.

Carcinoma In-Situ:
An early stage in development, when the cancer is still confined to one layer of tissue. Cancers diagnosed at this stage are highly curable.

Chemotherapy:
The treatment of diseases such as cancer by drug therapy.

Childhood Cancer Protocols:

• Childhood Cancer Group (CCG):
  The Children's Cancer Group (CCG) is a national cooperative research organization which was founded in 1955. It is devoted to the development of new treatments and cures for the cancers of children and young adults. It conducts research on the biology of these cancers, their causes, and the long term follow-up of cured patients into adult life. The Group's highest scientific priority is to transition new biological findings, learned from laboratory research, into clinical trials which can benefit children with cancer.
  
  
• Pediatric Oncology Group (POG):
  The Pediatric Oncology Group is a National Cancer Institute-sponsored clinical trials cooperative group of individuals and institutions dedicated to controlling cancer among children and adolescents. Since their inception in 1980, POG has enrolled nearly 50,000 children and adolescents in state-of-the-art pediatric cancer research studies.

Cobalt Machines:
Radiation treatments can be administered externally or internally, depending on the type and extent of the tumor. External radiation treatment are administered by machines that deliver high-energy radiation. The Cobalt-60 machine was the first megavoltage machine, and is still used in institutions throughout the world.

Colonoscopy:
A procedure which uses a lighted, tubular instrument with a viewing device called a colonoscope to examine the colon.

Colposcopy:
Visual examination of the tissues of the cervix and vagina by inserting a magnifying instrument called a colposcope.

Computed Tomography (CT) or Computerized Axial Tomography (CAT):
The gathering of anatomical information from a cross-sectional plane of the body, presented as an image generated by a computer synthesis of x-ray transmission data obtained from many different directions on the given plane.

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Demography:
The study of populations, especially with reference to population size, density, fertility, mortality, growth, age distribution, migration, and vital statistics, and the interaction of all these with social and economic conditions.

Detection:
The discovery of a physical abnormality in a person who might or might not show symptoms of disease. Detection can result from self-examination or special screening and/or diagnostic tests administered by health care professionals.

Dialysis:
A process whereby wastes and excess fluid are removed from a patient's blood.

Digital rectal examination (DRE):
A procedure in which a physician inserts a gloved finger into the rectum to feel for anything not normal.

Distant:
A neoplasm that has spread to parts of the body remote from the primary tumor either by direct extension or by discontinuous metastasis.

Double Contrast Barium Enema:
An examination of the colon by X-ray after administration of barium, a contrast medium. Additional X-rays are taken after the patient has expelled the barium.

Dysplasia:
The abnormal pathological development of cells, indicating possible malignancy.

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Early Detection Programs:
Programs used with diseases that have characteristics appropriate for screening and a valid screening test; those who test positive are referred for further evaluation by a subsequent diagnostic test or procedure to determine whether they do have the disease.

Enteral Feeding:
The term used to describe nourishment put directly into the stomach or intestines by a method other than chewing or swallowing. Generally used with patients that have trouble taking any nourishment by mouth or to supplement those patients unable to take enough nourishment by mouth.

Enterostomal Therapy:
A specialized field of nursing involving the care of patients with abdominal stomas, dermal wounds, pressure ulcers, incontinence and related skin conditions.

Epidemiology:
The study of the distribution and causes of disease occurrence in a population.

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Fecal-occult Blood Test:
Examination of stool for traces of blood not visible to the naked eye.

Five-Year Survival:
A term commonly used as the statistical basis for successful treatment. A patient with cancer is generally considered cured after five or more years without recurrence of the disease.

Flexible Sigmoidoscopy:
A procedure which uses a thin, lighted tuble about ten inches long called a sigmoidoscope to examine the first ten to twelve inches of the rectum.

Full-field Digital Mammography:
Examination of the breast by using a computer along with the X-ray to obtain a finer resolution. The computer can compensate for underexposed or overexposed images.

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Global Budgets:
Proposed limits to all health care spending.

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Health Care Professionals:
Practitioners of disease prevention, detection, treatment and rehabilitation. These include physicians, nurses, dentists, dietitians, health educators, social workers and therapists, among others.

Helical CT Scanning:
Spiral or Helical CT scanners have a rotating frame that can rotate continuously in the same direction causing the path of the X-rays to describe a spiral or helix. Patients can have entire anatomic regions such as the lungs scanned during one 20 to 30 second breath hold.

High-Risk Group:
When the chance for developing cancer is greater for an individual or a group of people than it is for the general population, that individual or group is thought to be high-risk. People may be considered to be high-risk for many factors or combinations of factors, including a family history of a disease, personal habits, or exposure to products which can cause cancer in the environment or workplace.

Home Health Care:
Basic to skilled care provided in the patient's home.

Hospice:
Comprehensive program designed to address the physical, emotional and spiritual needs of individuals and their families who face a life-threatening illness.

Hyperthermia:
Therapeutically inducing a high fever; research has shown that cancer cells are normally weaker than normal healthy cells and cannot tolerate high body temperatures.

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Immunotherapy:
Biological therapy/treatment to stimulate or restore the ability of the immune system to fight infection and disease.

Incidence:
The number of occurrences of a given disease within a population. Cancer incidence is the number of new cases of cancer diagnosed in one year. Data on the incidence of cancer in Texas are maintained by the Texas Cancer Registry at the Texas Department of Health.

Incidence Rate:
Calculated by dividing the number of new cases of a particular cancer during a given period of time by the number of people known to be at risk.

Infusion Therapy:
Slow and/or prolonged intravenous delivery of a drug or fluids.

In situ:
In place; localized and confined to one area. Carcinoma in situ is an early stage of the development of a cancer, when it is still confined to one layer of tissue. Many cancers diagnosed at this stage have a high cure rate.

Internal Radiation:
Internal radiation, or brachytherapy, is the use of radioactive isotopes for either temporary or permanent implants. Methods of delivering brachytherapy include intracavitary or interstitial placement of sources, instillation of colloidal solutions, and parenteral or oral administration. Sealed sources are encapsulated in a metal see, wire, tube or needle. Unsealed radioactive sources are prepared in a suspension or solution.

Interstitial Irradiation:
A type of internal radiation treatment using either temporary or permanent implants.

Intracavitary Irradiation:
Irradiation into a cavity, or space, specifically the abdomen, pelvis, or the chest.

Intra-operative Irradiation:
A large dose of external radiation is directed at the tumor and surrounding tissue during surgery.

IV Hyperalimentation:
Intravenous administration of nutrients beyond normal requirements.

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JCAHO:
Joint Commission on Accreditation of Healthcare Organizations is the nation's oldest (founded in 1919) independent, not-for-profit and largest standards-setting and accrediting body in healthcare. The mission of the JCAHO is to improve the quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care. The Joint Commission is recognized nationwide as a symbol of quality which indicates that an organization meets certain performance
standards.

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Linear Accelerators:
Linear accelerators, using high-energy x-ray beams, are now the most commonly used machines. Technological advances have permitted the development of machines with increased energy, allowing for precise treatments of deep seated tumors with less damage (i.e. skin sparing) to superficial tissues.

Local:
An invasive neoplasm confined entirely to the organ of origin.

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Magnetic Resonance Imaging (MRI):
A procedure using a magnet linked to a computer to create pictures of areas inside the body.

Malignancy:
The tendency of certain diseases to become progressively worse. A
malignancy is often resistant to treatment and can result in death.

Mammography:
A screening and diagnostic technique that uses low-dose x-rays to find tumors in the breast.

Managed Competition:
Centralized management of the distribution of goods and services from various providers. It is often considered to be synonymous with a market-based approach because it allows consumers to choose from among competing health plans. In the context of national health care reform, it would include a defined package of basic benefits with supplemental options.

Medicare Certification:
Process which focuses on provider and supplier specific process quality indicators and outcome measures in order to improve care provided to beneficiaries.

Metastasis:
The spread of cancer cells to new areas of the body.

Morbidity:
Any departure, subjective or objective, from a state of physiological or
psychological well-being. In this sense, sickness, illness, and a morbid condition are synonymous.

Mortality Rate:
Calculated by dividing the number of people who have died of a particular cancer during a given period of time by the total population at risk.

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Neoplasm:
A new growth of tissue serving no physiological function; see tumor.

Neuroblastoma:
A malignant tumor formed of embryonic ganglion cells.

Nuclear Imaging:
Nuclear medicine studies document organ function, in contrast to conventional radiology, which creates images based upon anatomy. Many of the nuclear studies can measure the degree of function present in an organ. Images may be obtained immediately, as the isotope is injected, or up to several days later to allow sufficient radionuclide to collect in the selected organ or system.. For example, when tumors metastasize to bone they may stimulate abnormal bone production. This abnormality causes more of the radionuclide to be in
this region.

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Obesity:
A condition in which a person has abnormally high amounts of unhealthy body fat; medically defined as a body mass index of 30 or greater.

Occupational Therapy:
The use of avocational or vocational tasks as a form of therapy.

Oncology:
A science dealing with the physical, chemical, and biologic properties and features of cancer, including causes and the disease process.

Oncologist:
A physician who, after extensive training, specializes in cancer treatment.

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Palliative Care:
Treatment to relieve, rather than cure, symptoms caused by cancer. Palliative care can help people live more comfortably.

Pap Test:
A simple microscopic examination of cells. The Pap test can detect cancer of the cervix at an early, highly curable stage.

Physical Therapy:
The treatment of pain, disease, or injury by physical and mechanical means. For example, massage, regulated exercise, water, heat, or light may be used as a part of physical therapy.

Plasmapheresis:
Removal of whole blood from the body, separation of its cellular elements by centrifugation, and reinfusion of them suspended in saline or some other plasma substitute, thus depleting the body's own plasma protein without depleting its cells.

Population Estimates:
Estimates generally use existing data collected from various sources.

While projections and estimates may appear similar, there are some distinct differences between the two measures. Estimates are for the past, while projections are based on assumptions about future demographic trends at the time the projections are produced.

An estimate and a projection available for the same date (e.g., July 1997), may not agree because they were produced at different times based on different assumptions.

Population Projections:
Projections are estimates of the population for future dates. They illustrate plausible courses of future population change based on assumptions about future births, deaths, international migration, and domestic migration. Projected numbers are based on an estimated population consistent with the most recent decennial census as enumerated, projected forward using a variant of the cohort-component method.

Positron Emission Tomography (PET):
Tomographic imaging of local metabolic and physiological functions in tissues, indicating the presence or absence of disease; the image is formed by a computer synthesis of data transmitted by positron-emitting radionuclides that have been incorporated into natural biochemical substances administered to the patient.

Prevalence:
The number of persons in a population with a given disease at a given time.

Prevention:
Primary prevention is the reduction or control of causative factors of potential health problems. This includes reducing or eliminating various risk factors such as quitting smoking to reduce the risk of lung cancer and wearing sunscreen to reduce the chances of developing skin cancer and environmental measures such as reducing exposure to toxic or carcinogenic substances. This category also includes health-service interventions, such as vaccinations or such preventive "therapy" tools as fluoridated water supplies or dental sealants.

Secondary prevention is the early detection and treatment of health problems, such as using mammography to detect breast cancer and Pap tests to detect cervical cancer, along with the resulting diagnosis and initial treatment.

Tertiary prevention involves providing appropriate supportive and rehabilitative services to minimize morbidity and maximize the quality of life, such as the rehabilitation of injuries and the prevention of secondary complications.

Prostate Cancer:
Prostate cancer starts in the prostate gland. The prostate gland is found only in men; therefore, only men get prostate cancer. The prostate is about the size of a walnut. It is just below the bladder and in front of the rectum. The tube that carries urine (urethra) runs through the prostate. (from American Cancer Society web site)


Prostate-specific Antigen (PSA):
A gland protein made by the prostate. Levels in the blood often go up in men with prostate cancer. The PSA test is used to help find prostate cancer, as well as to monitor the results of treatment.

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Radiation Therapy:
Cancer treatments which utilize high-energy waves or particles of radiation.

Regional:
A neoplasm that has extended beyond the limits of the organ of origin directly into surrounding organs or tissues; into regional lymph nodes; or both direct extension and regional lymph node involvement.

Rehabilitation:
Programs which help patients adjust to health problems or disablement and return to a full productive life. Rehabilitation may involve physical restoration, such as the use of prostheses, or emotional help such as counseling or providing emotional support.

Remission:
A state or period during which the symptoms of cancer are not present.

Remote After-loading:
Encapsulated radioactive elements are placed in body cavities or inserted directly into tissues with suitable applicators. The applicator is usually placed into the body cavity or tissue surgically or using fluoroscopy. The applicators, usually plastic or metal tubes, may be sutured into or near the tumor to hold them in place. When the patient is returned to their hospital room, the radioactive isotope is placed into the applicator. This "after-loading" technique is used to reduce the radiation exposure to hospital personnel. These implants provide radiation to a limited area which minimizing normal exposure. Radiative implants are used in the treatment of cancers of the tongue, lip, breast, vagina, cervix, endometrium, rectum, bladder, and brain.

Respite Care:
Care provided to the patient while the family or other care givers are given time to recuperate from the daily stress of providing long-term. This may require temporary help from other family members, or from community respite programs like those offered by the Visiting Nurses Association.

Risk Assessment:
The evaluation of an individual's personal and family history, often by using questionnaires to estimate the degree to which that person is at risk for developing certain types of cancer. For example, assessing an individuals risk of developing cancer can provide information on ways to lower personal risk and can make the person aware of early warning signs and the type and frequency of screening programs to follow.

Risk Factor:
Something that increases a person's chance of developing a disease; an aspect of personal behavior or lifestyle, an environmental exposure, or an inborn or inherited characteristic, which on the basis of epidemiologic evidence is known to be associated with health-related conditions.

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Screening:
Checking for disease when there are no symptoms; usually concerned with chronic illness and aims to check for disease not yet under medical care.

Self-Referred Patients:
Patients which refer themselves for a procedure such as mammography or refer themselves to a hospital without a physician's referral.

Simulators - Simulation and Treatment Planning:
The purpose of treatment planning is to determine the best way to deliver the radiation treatment and to limit the radiation dose to normal tissues. An x-ray machines called a simulator is used to visualize and define the exact treatment area. Temporary dye or permanent tattoos about the size of a small freckle may be used to mark reference points on the skin to allow exactly the same are to be treated each day.

Sliding Scale Fee:
A fee based on the individual's ability to pay for services; may vary from 100% of the fee to 0%.

Small Volume Portable Pumps:
Pumps used for infusion that can be used at home or in nursing homes.

Squamous Cell Carcinoma:
A common form of skin cancer which, when detected and treated early, will result in complete cure.

Stage:
A distinct phase in the course of a disease. Stages of cancer are typically defined by the degree of containment or spread of the tumor: in situ, localized, regional or distant spread.

Subclavian/Long-line Catheter:
A tubular instrument for the passage of fluid from or into the subclavian vein.

Survivor:
The Center for Disease Control and Prevention (CDC), Amerian Cancer Society (ACS), and National Cancer Institute (NCI) currently use the term cancer survivor to describe those who have been diagnosed with cancer and the people in their lives who are affected by the diagnosis, including family members, friends, and caregivers.

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Tumor:
An abnormal mass of tissue that is not inflammatory, arises from cells of pre-existent tissues, and serves no useful purpose. See Neoplasm.

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Ultrasonography:
An exam in which sound waves are bounced off tissues and the echoes are converted into a picture. Ultrasound can reveal information about the shape, texture, and composition of tumors and cysts that cannot be seen on conventional x-ray studies. For example, suspicious lumps found during a mammographic study can be examined with ultrasound to determine whether they are benign cysts or solid masses.

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Ventilator Care:
The care of patients who need an apparatus for producing mechanical ventilation (breathing), especially in cases of paralysis or inadequate spontaneous ventilation.

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